Assessment After The House Vote

Yesterday the Republican controlled House of Representatives voted narrowly (217-213) to pass the American Health Care Plan which in their eyes is a “repeal and replace” healthcare option. Amazingly, the House rushed to vote with no “official” (CBO) estimate of the cost or impact. Hmmm.

When the vote was announced, Republican leaders including Vice President Pence stood before photographers applauding each other. Was it a day of rejoicing or a day which will bring telling consequences?

The AHCA retains much of Obamacare but has reduced its benefits and scope. Senator Rand Paul has aptly called AHCA “Obama-lite”. What the AHCA is not light about is the individual mandate and the mix of revenue offsetting taxes designed to make the keep federal budget revenue neutral, they are gone. I wonder whether that is what the GOP leaders were cheering about?

There will be passionate speeches about what the House AHCA version does and does not do. And, until the bill actually goes into effect, no one can be 100% sure. What can be sure is that without the additional income generated by the individual mandate and the special taxes, is that the GOP replacement will (1) swell the deficit since the government must make the insurers whole in some way, (2) Republicans will be content to allow the marketplace to price some Americans out of the market bragging that these fellow Americans made patient centered choices, or (3) some combination of both. The AHCA is less coverage for more money for fewer people. Hmmm.

Do the math. Minimum wage is $7.50 per hour, 40 hours (if one is lucky to find work) per week is $300. Therefore in a year this low wage American is earning $15,600. According to published reports, individual purchased family insurance cost $1021 per month, or $12252 per year. Hmmm, $15,600 before food and shelter, and healthcare of $12,252 which must come off the top. Do you think there will be incentives to offer less insurance coverage in order to get the yearly individual market coverage decreased?

How can a major party sleep knowing that its proposal will treat Americans of limited financial means (which could include full time, minimum wage earners) destine for less basic healthcare than more wealthier Americans? Would anyone think that we should ration basic sustenance for water or food based upon ability to pay?

The House vote marks a dark day for Republicans. All the masterful rhetoric the GOP will surely muster will not change the directional outcome. The American Health Care Act now heads to the Senate where it will meet another test.

Some GOP Senators think the House version is far too rich and would advocate an even stingier act. Others are more moderate and find the House version onerous. Regrettably most Republican Senators are likely to find the House bill as no obstacle to a good nights rest.